Epilepsy & Functional Neurosurgery Centre

The Epilepsy & Functional Neurosurgery Centre at SilverOak Health is a Level 4 comprehensive epilepsy programme providing the most advanced evaluation and surgical treatment available for patients with drug-resistant epilepsy. Despite the proven effectiveness of epilepsy surgery, it remains significantly underutilised — our programme is committed to timely identification and referral of surgical candidates, reducing the years of unnecessary medication burden that many patients endure before reaching evaluation.

Presurgical evaluation integrates prolonged video-EEG monitoring in our dedicated epilepsy monitoring unit, high-resolution epilepsy-protocol MRI, FDG-PET and ictal SPECT imaging, comprehensive neuropsychological assessment, and — for patients without a clear MRI lesion — stereo-EEG with intracranially implanted depth electrodes providing three-dimensional mapping of the seizure onset zone and propagation network. This non-invasive and invasive diagnostic pathway identifies surgical candidates across the full spectrum of epilepsy syndromes.

Surgical interventions include resective surgery — anterior temporal lobectomy for mesial temporal sclerosis (achieving seizure freedom in over 70% at two years), extratemporal focal cortical resection, and lesionectomy for focal cortical dysplasia and cavernomas. Laser interstitial thermal therapy offers a minimally invasive ablative option for deep or eloquent-region foci, performed under MRI guidance with real-time temperature monitoring. Corpus callosotomy for refractory atonic drop attacks significantly reduces fall-related injuries in this challenging population.

Deep brain stimulation of the anterior thalamic nucleus is offered as neuromodulation therapy for patients whose seizures cannot be adequately controlled by resective surgery. Vagal nerve stimulation and responsive neurostimulation — a closed-loop device that detects electrographic seizure activity and delivers responsive stimulation — complete our neuromodulation portfolio for non-resection candidates. Neuropsychological assessment before and after surgery guides counselling regarding cognitive risks and post-operative functional outcomes.

Functional neurosurgery beyond epilepsy encompasses movement disorder surgery — including deep brain stimulation for Parkinson's disease, essential tremor, dystonia, and obsessive-compulsive disorder — and spasticity management. Our functional neurosurgery MDT meets weekly, reviewing every patient's diagnostic evaluation and surgical plan with neurosurgeons, neurologists, neuropsychologists, and neuroradiologists to ensure that operative intervention is recommended only when the evidence clearly supports patient benefit.